This application is in response to the RFA """"""""Communications and HIV/STD Prevention"""""""" (RFA MH 01003) and requests 4 years of support to conduct a randomized trial of an intervention designed to improve health behaviors and quality of life among people living with HIV- AIDS. This secondary prevention study will determine whether a motivational-skills building intervention, guided by the Information- Motivation-Behavioral Skills (IMB) Model of health behavior change, increases personal capacity to access and effectively use information available on the Internet to empower the practice of health behaviors and improve health outcomes in people living with HIV-AIDS. The communications revolution has expanded the universal availability of information and created opportunities for millions of people with access to the Internet. Access to health communications and resources via the Internet has also demonstrated positive health outcomes for people with chronic illnesses. However, African-Americans, women, and the inner- city poor are at considerable disadvantage for using information technologies due to limited education, limited exposure to computers, and a sense of disconnection from advances in technology. The demography of AIDS suggests, and our preliminary studies confirm, that there is a significant information gap, or digital divide, between persons with HIV-AIDS who have and those who do not have sufficient information technology skills to use the Internet. The proposed research will test the efficacy of an information technology motivational-skills building intervention to improve information consumer skills and health benefits of information resources available via the Internet. The study will recruit, assess, and randomly assign 225 HIV positive men and 225 HIV positive women from community service agencies who possess at least a 6th grade reading level to receive either (a) 10-session motivational-skills building intervention designed to increase effective use of information technology; or (b) 10-session standard educational comparison group; or (c) 2-session minimal intervention control group. Participants will be followed for 12-months to assess the effects of the information technology motivational-skills building intervention on motivation to use the Internet, Internet use, health knowledge, internal health locus of control, social support, problem focused coping, health behaviors, health-related quality of life, and mental health outcomes. We will also test a mediation model based on the IMB model of health behavior adapted for Internet use and information consumer skills. In addition, we will examine the characteristics of HIV infected persons who utilize and benefit from increased access to information available on the Internet and identify personal and social factors that impede and facilitate use of information resources. If successful, the experimental intervention could be readily implemented as a community-based program by AIDS Service Organizations, health centers, and community-based Internet access providers.
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